LANSING, MI — Health care providers could refuse to perform certain medical procedures, and employers could opt not to provide coverage for certain medical services as a matter of conscience under a bill now headed to the House floor.

Republican-backed Senate Bill 975, the “Religious Liberty and Conscience Protection Act,” passed the Senate last week. It was reported with changes from the House Insurance Committee on Wednesday along party lines with Republican support. Committee Chairman Pete Lund, R-Shelby Township, said he expects the bill to pass.

Since 1978, state law has allowed hospitals, doctors and other medical professionals to refuse to perform abortions.

The new bill goes beyond that, allowing employers and health insurance providers to refuse to pay for abortions, contraception or other services and medications that they oppose as a matter of conscience. Similar legislation has been discussed by lawmakers for about 10 years.

It addresses concerns over the portion of the Affordable Care Act that requires insurers and employers to provide free contraception including birth control and sterilization. The mandate has been the subject of several lawsuits from Catholic and other religious groups.

The Senate bill also offers liability protection to health facilities, providers and payers who decide not to perform or offer coverage for any kind of medical service, such as sterilization or care in certain end-of-life situations.

There are exceptions for patients who need emergency care and no one else is available, or if the objection request is made in the presence of the patient. Employees and job applicants are protected from discrimination based on their objections, but not if the objectionable service is a regular or substantial part of the job.

The bill is intended to help protect religious freedom, while still ensuring patients receive the best medical care available, said bill sponsor Sen. John Moolenaar, R-Midland.

“It’s important to note that this legislation would not allow for the refusal of care to a group of individuals,” Moolenaar said. “This legislation before you today only applies to health services.”

The House added language to ensure that services could not be denied to patients based on their health condition, race, religion, color, national origin, sex, age, disability, marital status, sexual preference or source of payment.

The changes were made to ease concerns that a doctor could refuse to serve people who are gay or treat patients with a sexually transmitted disease if they’re not married.

Democrats and certain civil and women’s rights groups maintained their opposition to the bill.

“What strikes me is that the patient is forgotten, and their religious beliefs and their conscience, and it seems to me that they should be the number one consideration,” said Rep. Marcia Hovey-Wright, D-Muskegon.

She said the legislation is directed at women, and would prevent them from getting the service they need because somebody with different religious beliefs disagrees with it.

Issues also were raised by Michigan Consumers for Healthcare, a coalition of health care and other advocacy organizations.

“We have big concerns about how this affects people in geographic areas of the state that don’t have a lot of access, or as Rep. Hovey-Wright has brought up, that are served by only one hospital system that might entirely disagree with providing services for a particular population,” said Ryan Sullivan of Michigan Consumers for Healthcare. “That would mean that an individual from those areas might be able to get care in other parts of the state, but they might not be able to afford to travel or might not be medically stable enough to do so.”

Representatives from the Michigan National Organization for Women, Michigan Department of Civil Rights and American Civil Liberties Union of Michigan testified against the bill.

Michigan Catholic Conference and Michigan Right to Life offered their support.

“The Chicken Little factor on this legislation and the testimonies I’ve heard to this point really take me to the edge of my patience,” said Ed Rivet, legislative director for Michigan Right to Life.

It will be up to individual institutions to decide how to handle individual employee objections. One person raised the controversial 2005 case of Terry Schiavo, who was the subject of end-of-life lawsuits while she was in a "prolonged vegetative state."

“The bill has long been designed to address cases like Terry Schiavo. If I’m a nursing home worker and I don’t want to be involved in the care of a patient who’s being purposefully dehydrated to death, please assign me to something else,” Rivet said.